Individual
DR. JAY C JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1010 THREE SPRINGS BLVD, DURANGO, CO 81301-8296
(970) 259-2525
Mailing address
PO BOX 394, GRETNA, NE 68028-0394
(877) 406-2916
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
46369
CO
2085R0202X
Diagnostic Radiology Physician
MD00044954
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
341184
—
AZ
05
—
46280570
—
NM
05
—
51508851
—
CO
01
—
P00664636
RAILROAD MEDICARE
CO
Enumeration date
09/02/2006
Last updated
07/07/2015
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